Corey Amy L, Snyder Stacy
Center for Children's Cancer & Blood Diseases, Riley Hospital for Children at Clarian North, Carmel, Indiana 46032, USA.
J Pediatr Oncol Nurs. 2008 Jul-Aug;25(4):208-12. doi: 10.1177/1043454208319971. Epub 2008 Jun 6.
Infections are the most common complication in patients receiving treatment for cancer with neutropenia being the primary risk factor for the development of an infection. In the neutropenic patient, bacteremia remains a significant cause of mortality. Although the literature reports that prompt empiric antibiotic therapy to prevent death caused by virulent organisms is the standard of care, the literature fails to identify what prompt antibiotic administration means. Door/fever-to-patient antibiotic delivery was evaluated as a quality control measure in a new children's hospital. Initially, door/fever-to-patient time was significantly delayed. Collaboration between pharmacy, hospital bed control, medical, and nursing staff resulted in many changes in practice by all groups. As a result, the goal for prompt antibiotic delivery of thirty minutes or less is now achievable.
感染是接受癌症治疗患者中最常见的并发症,中性粒细胞减少是发生感染的主要危险因素。在中性粒细胞减少的患者中,菌血症仍然是一个重要的死亡原因。尽管文献报道迅速进行经验性抗生素治疗以预防由强毒力微生物引起的死亡是标准治疗方法,但文献未能明确迅速给予抗生素意味着什么。在一家新建儿童医院,将从门/发热到给予患者抗生素的时间作为一项质量控制措施进行了评估。最初,从门/发热到给予患者抗生素的时间显著延迟。药房、病床管理部门、医疗和护理人员之间的协作导致了所有团队在实践中的许多改变。结果,现在可以实现30分钟或更短时间内迅速给予抗生素的目标。